In a recent report, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) found that Medicare improperly paid some claims for home health services with 5-7 visits in a payment episode. Review the Medicare Home Health Benefit and Home Health Prospective Payment System (PPS) booklets to properly bill for services slightly above the low utilization payment adjustment threshold.

Visit the Centers for Medicare & Medicaid Services' (CMS) Home Health PPS webpage to stay informed about the latest policy and payment updates:

• Calendar Year 2021 Home Health PPS final rule
• Section 10.6 – Medicare Benefit Policy Manual, Chapter 7
• Section 10.1.17 – Medicare Claims Processing Manual, Chapter 10
• Section 6.2 – Medicare Program Integrity Manual, Chapter 6